Community Based Referral and Counter Referral System. Strategy for Improving Maternal and Child Health: A quasi-experimental Case Study of Resource Constraint Setting

      Аннотация: Existing evidence show that every day approximately 810 women die from pregnancy and childbirth related causes. 94 % of these deaths occur in low income countries with 80% occurring at home. Absence of reliable and organized community based referral systems is one of the factors contributing to these deaths. Where there is organized and reliable community referral systems, 70% of the pregnant women deliver in the hospital. The aim of this quasi-experimental study was to develop and test a community based referral and counter referral system where pregnant women, home deliveries and other common household illnesses were identified, counseled and referred to a link hospital. One hundred CHVs were trained on the referral model, issued with referral tools and distributed to cover 100 villages where they regularly visited 2209 HHs households for nine months. Fig 4.3 shows statistically significant increases in postnatal care attendances (166%; p-v = 0.007) and hospital deliveries (135%; p-v=0.001) respectively. It was further observed that CHVs identified and referred up to 38 common ailments to the hospital.The authors recommend scaling of the model in poor settings.

Ключевые слова: Referral rate, Median delay, Counter-Referral success rate, Referral structure, Receiving Structure, Referral compliance rate